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Five Questions With: Fred Trapassi Jr.

"ALCOHOL AND drug abuse take a heavy toll on workplaces in Rhode island – and throughout the country – in terms of absenteeism, stress, poor work performance, health issues, safety issues and criminal behavior," said Fred Trapassi, vice president for Rhode Island programs, director of New England Insurance and Self-Pay Initiative, Phoenix Houses of New England.

In terms of well-being, Rhode Island was recently ranked 35th nationally in the 2011 Gallup-Healthways Well-Being Index, with Hawaii ranked first and West Virginia ranked last, when survey respondents were asked about physical health, daily habits, access to food, shelter and their satisfaction with work and community.

One thing the survey didn’t measure were the good things that are happening in Rhode Island’s network of health care services in efforts to create a more seamless system of care for those who have are dealing with problems of addiction and recovery.

A new “recovery” high school was approved by the Rhode Island Board of Regents for Elementary and Secondary Education, under the direction of the Providence Center, which will open in September. And, Phoenix Houses of New England recently merged with the Rhode Island Council on Alcoholism and Other Drug Dependence to join forces and resources to improve conditions for treatment and recovery.

Providence Business News asked Fred Trapassi Jr., vice president for Rhode Island programs, director of New England Insurance and Self-Pay Initiative, Phoenix Houses of New England, to illuminate what this merger will mean for the community – and for businesses.

PBN: How will the merger between Phoenix Houses and the R.I. Council on Alcoholism and Other Drug Dependence improve the delivery of services to Rhode Islanders in recovery?

TRAPASSI: This merger is a great combination of two of Rhode Island’s leading providers. By combining Phoenix Houses and the council’s forces and resources, the spectrum ofcomprehensive treatment and aftercare services available for people in early recovery is significantly expanded.

Research shows that individuals who have completed treatment stand a far greater chance of success if they can spend a significant amount of time living in a sober, stable, supportive environment that reinforces the lessons and practices learned during their treatment stay.

With the 54 beds currently available through the council, more individuals in recovery are able to take advantage of this opportunity. By combining resources, we make access to services seamless and, in many cases, immediate from virtually anywhere in Rhode Island. At the same time, it allows us to move clients throughout the system quickly in case of a relapse.

PBN: What kinds of treatment options are available for people in recovery from drug and alcohol addictions?

TRAPASSI: There are a myriad of treatment options now for both adults and adolescents in our state; Phoenix House provides a full continuum of services. The more traditional options include prevention, early intervention, detoxification, outpatient and intensive outpatient services, partial hospitalization, and residential treatment.

There are also pharmacological interventions such as Soboxone, methadone, plus anti-abuse and 12-step options such as Alcoholics Anonymous and Narcotics Anonymous.

Phoenix House looks at all these treatment options globally, but the type of treatment provided in each individual case depends on that person’s needs. One size does NOT fit all, and it’s important that we tailor treatment to address those needs.

Through this merger with the council, our continuum of care has now broadened with the addition of the very important component of a number of transitional living facilities for those who have completed residential treatment, but still need the support of living in a sober community during the vulnerable months of early recovery.

PBN: Can you quantify the impact of drug and alcohol addiction on workplaces in Rhode Island? What are the costs?

TRAPASSI: Bear in mind that employers are the largest purchasers of health care. Beyond that, alcohol and drug abuse take a heavy toll on workplaces in Rhode island – and throughout the country – in terms of absenteeism, stress, poor work performance, health issues, safety issues, and criminal behavior including pilferage, embezzlement and violence.

But we really should look at this question another way, from the point of view of the community as a whole. Substance abuse has an enormous and devastating effect on families, parents, children, spouses, friends and loved ones. Everyone is affected in some way when a friend or family member has a drug or alcohol problem.

The economic costs to the community are also enormous, in terms of crime, legal expenses and incarceration. The costs of medical and emergency treatment are staggering. It has been estimated that up to 70 percent of medical costs nationally can be attributed to alcohol and drug abuse.

We view substance abuse as a chronic but controllable disease like diabetes, where if you are careful and sensible in your habits – avoid sugar, get enough exercise – you can avoid serious and costly problems, including amputation.

PBN: The danger of prescription drugs has been magnified by the untimely death of Whitney Houston. What are your programs seeing in terms of the growing misuse and abuse of prescription drugs?

TRAPASSI: There’s no doubt that the loss of such a talent is a tragedy. We hear bad news every day about the unprecedented epidemic nationwide of the misuse and abuse of prescription drugs. In addition, recent federal government surveys have found some of the highest national rates of marijuana, cocaine and alcohol use, as well as binge drinking, among Rhode Island’s 12- to 17-year-old age group.

In our Drug Court program we are seeing a significant rise in adolescent use of prescription meds as well as arrests for their possession and/or sale. There is also an increased use of anti-depressants like Xanax and Klonopin, and of opiates, including oxycodone and oxycontin, especially among adolescents living in or near cities and communities where heroin use is on the rise. What is particularly alarming is that we are seeing more misuse of legitimate prescriptions being provided by the adolescents’ own doctors as well.

Taking adults as a group, there is a definite increase in prescription misuse along with dependence – not just with benzodiazepines, but also with opiates. Most are prescribed for pain, but “doctor shopping” among users is getting more and more common. As with adolescents, the family medicine cabinet and old prescriptions are an increasing source of these drugs.

We should also look at the chronic substance-abusing populations who may not have had access to health or psychiatric care for years. When they enter treatment and become sober, they often display psychiatric symptoms that have never been addressed. Treatment at that point might include controlled usage of an opiate or benzo, but unfortunately these medications are sometimes cheaper to use in treating such diagnoses than other psychotropic medications or face-to-face clinical interventions, especially for indigent populations.

It’s clear that we are seeing these increases in all age groups, but of special concern is the increase in young adults (ages 18 to 24) who are becoming addicted to opiates. Another major concern is the increase in adults who have gone their entire lives without a drug problem, but who may have a serious accident, medical or psychiatric issue, and become addicted in a short period of time. These older clients are buying drugs from friends; they are “doctor shopping” or buying on the street.

PBN: What role can the business community play in addressing these issues?

TRAPASSI: Businesses have to realize that addiction affects the entire community. It leads to greater high school drop-out rates, unwanted pregnancies, higher rates of criminal offenses such as driving under the influence, drug possession, breaking and entering, robbery, prostitution, assaults, and murder. This in turn leads to the decay of neighborhoods, with families moving away to seek safer environments, and this ultimately impacts the businesses in those communities. Business owners need to see the connections between their ability to be prosperous and the community’s ability to thrive.

One very important contribution employers can make in the fight against substance abuse is by developing education and prevention programs for staff, enforcing drug-free workplace policies, and providing employee-assistance programs (EAPs) to offer options for treatment.

Given the immense cost of substance abuse to us all, businesses must become more proactive in combating this devastating nationwide epidemic. For small businesses, some suggestions might include evaluating your business to see if you are contributing to the problem directly, for instance by selling drug paraphernalia or synthetic drugs that are not yet illegal; or indirectly by turning a blind eye to other companies that do such things. Community businesses can also help by sponsoring good, clean, sober activities, such as little league teams, crime watches, prescription medication buy-backs, rehabilitation of parks, and graffiti removal.

Business leaders must accept that drug experimentation is common and even acceptable to many of the individuals in their communities, in the same way that cigarette smoking was among past generations. The cost of doing nothing will eventually have a huge impact on business.

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